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van der Eijk Y, Tan GPP, Makhbal B. Is It Time to Ban Flavored Cigarettes in Asia-Pacific Countries? A Scoping Review. Asia Pac J Public Health 2024:10105395241266042. [PMID: 39054851 DOI: 10.1177/10105395241266042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Flavored cigarettes encourage youth smoking and deter quitting. No country in Asia-Pacific, a region with some of the world's highest smoking rates, has regulated tobacco flavors. We examined market data, academic literature, and gray literature to describe what is known on flavored cigarettes in the Asia-Pacific region. Of the 12 countries for which market data were available, ten had substantial flavored cigarette market shares ranging from 10% to 97%. With no regulations and growing markets for flavor capsule variants, the tobacco industry's ongoing promotion of flavored cigarettes, which targets primarily youth and women, is expected to drive further increases in smoking prevalence. There are significant research and monitoring gaps on the industry's marketing tactics and use of flavored cigarettes in the region. Given the large market shares, Asia-Pacific countries stand to benefit substantially from a tobacco flavors ban.
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Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Grace Ping Ping Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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Tseng TY, Welding K, Saenz-de-Miera B, Grilo G, Cohen JE. The Use of Packaging Descriptors in a Rapidly Growing Market for Capsule Cigarettes: Evidence From Mexico. Nicotine Tob Res 2024; 26:1014-1021. [PMID: 37987638 PMCID: PMC11260890 DOI: 10.1093/ntr/ntad208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/13/2023] [Accepted: 10/12/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION The global market for capsule cigarettes has grown rapidly, especially in Latin America. This research examined the sales trends and patterns as well as packaging characteristics of capsule cigarette in Mexico in recent years. METHODS National data on cigarette sales in Mexico between October 2018 and September 2021 licensed from NielsenIQ were supplemented with cigarette pack pictures and Internet searches to determine whether characterizing flavor, concept flavor, and action descriptors were used. Market share in sales value and volume was calculated by capsule and flavor status, descriptors, price tier, manufacturer, pack size, and cigarette length for the whole time period and for each month. Number of unique brand variants was also examined. RESULTS Capsule cigarette sales totaled US$4.29 billion or 30.99 billion sticks during the assessed period, comprising 37.7% of the cigarette market share in sales value or 35.5% in sales volume. Over half of capsule cigarettes sold during this time period had concept flavor descriptors, 17.8% contained characterizing flavor descriptors, and 15.1% contained action descriptors that were suggestive of the interactive aspects of capsules. The monthly market share of capsule cigarette sales volume among all cigarette sales in Mexico increased steadily from 33.3% in October 2018 to 37.3% in September 2021. CONCLUSIONS The expanding capsule cigarette market in Mexico is concerning, given the product's associated misconceptions of reduced harm and greater appeal among youth. Findings underline the need for enhanced regulations to address the public health threat posed by capsule cigarettes. IMPLICATIONS Capsule cigarettes have a substantial market share in Mexico, with increasing popularity. Descriptors and other product characteristics such as cigarette length might be used to increase the appeal and target particular populations. Policy makers should consider banning capsules and flavors in cigarettes including descriptors or other indication in product presentation that could be perceived as denoting a taste, aroma, or sensation, and making the appearance and design of tobacco products more commensurate with the harm they cause by adopting plain and standardized packaging.
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Affiliation(s)
- Tuo-Yen Tseng
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kevin Welding
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Belen Saenz-de-Miera
- Department of Economics, Autonomous University of Baja California Sur, La Paz, Baja California Sur, Mexico
| | - Graziele Grilo
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Kyriakos CN, Zatoński MZ, Filippidis FT. Flavour capsule cigarette use and perceptions: a systematic review. Tob Control 2023; 32:e83-e94. [PMID: 34607888 PMCID: PMC10086486 DOI: 10.1136/tobaccocontrol-2021-056837] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/01/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This systematic review on flavour capsule cigarettes aims to examine prevalence, correlates of use, behaviours and perceptions of these products globally. DATA SOURCES A search of original, peer-reviewed research without restrictions in publication year, population, study design or language, using a combination of cigarette and capsule terms was conducted across four databases (Medline, Embase, Web of Science and Scopus), indexed until 30 April 2021. STUDY SELECTION Studies were included if they presented original, human subjects research on flavour capsule cigarettes. DATA EXTRACTION Two authors independently extracted data on main outcome results and assessed risk of bias using a validated quality assessment tool (QATSDD). DATA SYNTHESIS Of 842 unduplicated database records and four studies from citation searching screened, 20 studies were included in the review. Studies reported data from 2009 to 2019 across eight countries, the majority of which used cross-sectional or focus group study designs. Current capsule use among smokers was highest in Chile and Mexico (40%) and was associated with younger age, and in some countries, with being female. Capsule cigarettes are perceived as tasting better, being smoother on the throat, more fun to smoke, and more attractive compared with non-capsule cigarettes, particularly among susceptible non-smokers and non-daily smokers. CONCLUSION Findings call for the adoption of comprehensive tobacco control policies that account for flavour capsules and similar iterations, which can increase appeal through flavours and innovative features. Continued monitoring and research of these products is critical, with particular attention to low-income and middle-income countries, which make up a disproportionately larger share of the capsule market.
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Affiliation(s)
- Christina N Kyriakos
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Mateusz Zygmunt Zatoński
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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Kyriakos CN, Zatoński MZ, Filippidis FT. Marketing of flavour capsule cigarettes: a systematic review. Tob Control 2023; 32:e103-e112. [PMID: 35042725 DOI: 10.1136/tobaccocontrol-2021-057082] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/05/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This systematic review aims to identify marketing elements of flavour capsule variants (FCVs), cigarettes that release flavour when a capsule(s) embedded in the filter is crushed. DATA SOURCES A search of original research without restrictions in publication year, population, study design or language using a combination of cigarette and capsule terms was conducted across four databases (Medline, Embase, Web of Science and Scopus), indexed until 13 December 2021, along with a citation search. STUDY SELECTION Studies were included if they presented original research relevant to marketing features of FCVs. DATA EXTRACTION One author performed data extraction and coded outcomes based on '4Ps' of marketing mix theory: product, place, price and promotion. The second author conducted a cross-check. DATA SYNTHESIS Of 2436 unduplicated database records and 30 records from other sources, 40 studies were included in the review. Studies were published between 2009 and 2021. Study methodologies primarily included content analysis of cigarette packs/sticks, review of tobacco industry documents and content analysis of advertising information. Findings suggest FCVs are marketed using a mix of strategies, particularly characterised by product innovation, timing market launches around tobacco policies, point-of-sale advertising and packaging to communicate a high-tech, customisable and flavourful product. CONCLUSION Findings illuminate the marketing strategies of FCVs that are likely driving their global growth, particularly among young people and in low and middle-income countries. Comprehensive tobacco control regulations are needed to close loopholes and curb industry efforts to circumvent existing policies in order to mitigate uptake of FCVs and other product innovations.
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Affiliation(s)
- Christina N Kyriakos
- Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK
| | - Mateusz Zygmunt Zatoński
- Department for Health, University of Bath, Bath, UK
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK
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Ogunnaike A, Gallegos-Carrillo K, Barrientos-Gutierrez I, Arillo Santillán E, Cho YJ, Thrasher JF. Why Smoke Flavor Capsule Cigarettes? Preferences and Perceptions Among Adult Smokers in Mexico. Nicotine Tob Res 2022; 24:1635-1644. [PMID: 35244723 PMCID: PMC9575969 DOI: 10.1093/ntr/ntac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/21/2022] [Accepted: 03/02/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Flavor capsule cigarettes are rapidly gaining global market share, particularly in Latin America; however, little is known about consumer profiles and perceptions since the diffusion of this product innovation has become more widespread. AIMS AND METHODS This paper compares profiles and perceptions of smokers who prefer flavor capsule cigarettes and those who do not in Mexico. We analyzed data from six online surveys of adult Mexican smokers (n = 4488) from 2018-2020. Participants identified their preferred brand variety characteristics (no capsule; one capsule; two capsules), and reported perceptions of their brand varieties' flavor, smoothness, harmfulness, and whether they smoke to control their appetite. Separate multinomial logistic models regressed preferred cigarette type on sociodemographic and smoking-related variables, as well as perceived benefits on preferred cigarette type, adjusting for covariates. RESULTS Most participants preferred capsule cigarettes (single capsule = 47.5%; double capsule = 12.9%). Flavor capsule users reported that their preferred varieties mostly tasted like menthol/mint (59% of single capsule users and 23% of double capsule users), cucumber (12% and 27%, respectively) or berries (10% and 22%, respectively). Females were more likely than males to prefer either single or double capsule cigarettes (AOR = 2.26 and 2.01, respectively). Preference for flavor capsules was also higher among younger smokers, e-cigarette users, those who smoke less frequently, and those who recently tried or plan to quit. Smokers who preferred capsules were more likely than non-capsule smokers to perceive their cigarettes as smoother, less harmful, and to smoke to control their appetite. CONCLUSIONS The high prevalence of capsule use and widespread perceptions of the benefits of capsules over traditional cigarettes may help explain why tobacco control policies have not reduced smoking prevalence in Mexico. IMPLICATIONS Flavor capsules are rapidly growing in popularity in many countries around the world, including Mexico. This study found that more Mexican adult smokers prefer brand varieties with capsules (60%) than without capsules (40%), that flavor capsule use strongly correlates with menthol cigarette use, and that perceived flavors of capsules range widely. Flavor capsule smokers have more positive smoking expectancies (eg, lower risk perceptions, dietary control) than noncapsule smokers. Capsules appeal particularly to women, young adults, less frequent smokers, and those who recently tried to quit. Policies should consider banning flavors in cigarettes, including capsules and other filter innovations.
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Affiliation(s)
- Adebusola Ogunnaike
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Katia Gallegos-Carrillo
- Epidemiology and Health Services Research Unit–Morelos, Mexican Social Security Institute, Cuernavaca, Mexico
| | - Inti Barrientos-Gutierrez
- Evaluation and Surveys Research Center/Tobacco Research Department, National Institute of Public Health, Mexico City, Mexico
| | - Edna Arillo Santillán
- Evaluation and Surveys Research Center/Tobacco Research Department, National Institute of Public Health, Mexico City, Mexico
| | - Yoo Jin Cho
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Evaluation and Surveys Research Center/Tobacco Research Department, National Institute of Public Health, Mexico City, Mexico
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Zatoński M, Silver K, Plummer S, Hiscock R. Menthol and flavored tobacco products in LMICs: A growing menace. Tob Induc Dis 2022; 20:39. [PMID: 35498956 PMCID: PMC9007155 DOI: 10.18332/tid/146366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION High income jurisdictions are banning menthol/flavored cigarettes and other tobacco products because they attract young people and create dependence. This study explores the importance of menthol and other flavored tobacco products for tobacco markets in low- and middle-income countries (LMICs), identifies countries where the menthol/flavor share is particularly high or rapidly growing, and identifies strategies tobacco companies are using to develop menthol/flavor markets. METHODS Research involved analysis of menthol/flavor market data from 2005 to 2019, a systematic review of academic literature, and a scoping exercise with our advocate contacts in LMICs. RESULTS The median menthol/capsule market share of the cigarette market grew significantly (p<0.05) between 2005 and 2019, both in lower and upper middle-income countries [lower: 2.5% (IQR: 0.5-4.0) to 6.5% (IQR: 3.6-15.9); and upper: 4.0% (IQR: 0.8-9.8) to 12.3% (IQR: 3.5-24.3)]. Countries with both high market share and high market share growth were Russia, Guatemala, Peru and Nigeria. No market data were available on low-income countries, but the academic literature suggested high prevalence of menthol use in Zambia. Tobacco industry strategies underpinning growth of menthol/flavored tobacco use in LMICs included in-store marketing and display, colorful packs and non-conventional flavor names. CONCLUSIONS Menthol/flavor tobacco products are a growing problem in LMICs. In addition to menthol/flavor bans, we recommend marketing bans, point of sale display bans and standardized packaging.
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Affiliation(s)
- Mateusz Zatoński
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, United Kingdom
| | - Karin Silver
- Tobacco-Tactics, Tobacco Control Research Group, Department for Health, University of Bath, Bath, United Kingdom
| | - Sarah Plummer
- Department for Health, University of Bath, Bath, United Kingdom
| | - Rosemary Hiscock
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, United Kingdom
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Evaluating the public health impact of partial and full tobacco flavour bans: A simulation study. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2022; 21:100414. [PMID: 35252911 PMCID: PMC8891712 DOI: 10.1016/j.lanwpc.2022.100414] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Methods Findings Interpretations Funding
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Kyriakos CN. Regulating flavours in cigarettes: A call to action. Tob Prev Cessat 2020; 6:33. [PMID: 32760867 PMCID: PMC7398135 DOI: 10.18332/tpc/122438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 11/24/2022]
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Brown J, Zhu M, Moran M, Hoe C, Frejas F, Cohen JE. 'It has candy. You need to press on it': young adults' perceptions of flavoured cigarettes in the Philippines. Tob Control 2020; 30:293-298. [PMID: 32447317 PMCID: PMC8077215 DOI: 10.1136/tobaccocontrol-2019-055524] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/17/2020] [Accepted: 03/21/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND The Philippines has a high smoking prevalence and one of the largest tobacco menthol market shares in the world. Flavour capsule cigarettes were introduced to the Philippines in 2013, most of which are menthol flavoured, and their market share is increasing. We explored perceptions of flavoured cigarette packaging among young adult Filipinos. METHODS We conducted eight focus groups with 63 young adults ages 18-24 years in Manila in 2019, stratified by gender and smoking status. We conducted a thematic analysis of the transcripts. RESULTS Most participants assessed relative harm of cigarettes based on strength, mainly determined by colour of the packaging. Menthol cigarettes with primarily blue packaging were considered less harmful than menthol cigarettes with primarily green packaging. Many participants considered flavour capsule packs most attractive, compared with non-flavoured and traditional menthol cigarettes, due to the colouring of the packs and expectations regarding taste. Some participants likened the capsules and the taste of flavour capsule cigarettes to candy, and many participants thought flavour capsule cigarettes would most likely be smoked by teenagers or young adults. CONCLUSIONS Young adult Filipinos believe that some menthol-flavoured cigarettes are less harmful than other flavoured cigarettes and non-flavoured cigarettes and find flavour capsule cigarettes attractive. A tobacco flavour ban and implementation of plain packaging might help reduce misperceptions of risk and make cigarettes less appealing.
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Affiliation(s)
- Jennifer Brown
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Meng Zhu
- Johns Hopkins University Carey Business School, Baltimore, Maryland, USA
| | - Meghan Moran
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Connie Hoe
- International Health Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Joanna E Cohen
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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